High prevalence of subclinical atherosclerosis in Brazilian postmenopausal women with low and intermediate risk by Framingham score

  • Ana Claudia Gomes Pereira Petisco
  • Jorge Eduardo Assef
  • Carlos Alberto de Jesus
  • Mohamed Hassan Saleh
  • Jose Eduardo Martins Barbosa
  • David Costa de Souza Le Bihan
  • Ibraim Masciarelli França Pinto
  • Simone Rolim Fernandes Fontes Pedra
  • Rodrigo Bellio de Mattos Barretto
  • Amanda Guerra de Moraes Rego Sousa
Original Paper


Cardiovascular diseases are the leading cause of mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal women in Framingham Risk Score (FRS) low and intermediate groups. Computed tomography (CT) and ultrasound (US) scans were performed in 138 asymptomatic postmenopausal women (56.1 ± 4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assess carotid intima-media thickness (CIMT) and identify carotid plaques (US). The mean FRS was 2.64 ± 2.13 %. The prevalence of increased CIMT, carotid plaques, increased CIMT and/or plaques, coronary artery calcification (CAC) >0 and aortic calcification (AC) were, respectively, 45.7, 37.7, 62.3, 23.9 and 45.7 %. Normal imaging tests were found in 22.4 %. SA, defined as at least one abnormal imaging test, was associated with age, FRS, waist-to-rip ratio, systolic and diastolic blood pressure, HDL-c and ApoA1 levels, and ApoA1/ApoB ratio. In logistic regression, SA was associated with higher age (OR 1.108, 95 % CI 1.010–1.215, p = 0.029) and lower ApoA1 levels (OR 0.979, 95 % CI 0.960–0.998, p = 0.029). SA was prevalent in Brazilian postmenopausal women with low and intermediate risk groups (FRS) and was associated with higher age and lower levels of ApoA1. Carotid atherosclerosis was the most common presentation of SA in this group.


Atherosclerosis Cardiovascular diseases Imaging Menopause Risk assessment 



Aortic calcification


Apolipoprotein-Related Mortality Risk Study


American Society of Echocardiography


Adult Treatment Panel III


Body mass index


Coronary artery calcification


Coronary artery disease


Carotid intima-media thickness


Cardiovascular diseases


Framingham Risk Score


National Cholesterol Education Program


Subclinical atherosclerosis


Years since menopause



The authors would like to thank the echocardiography and computer tomography staff and personnel for the continuous support during the course of this study.

Compliance with ethical standards

Conflict of interest

This research was developed according to ethical standards statements and authors declare no conflict of interests related to the content of this manuscript.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Ana Claudia Gomes Pereira Petisco
    • 1
  • Jorge Eduardo Assef
    • 1
  • Carlos Alberto de Jesus
    • 1
  • Mohamed Hassan Saleh
    • 1
  • Jose Eduardo Martins Barbosa
    • 1
  • David Costa de Souza Le Bihan
    • 1
  • Ibraim Masciarelli França Pinto
    • 1
  • Simone Rolim Fernandes Fontes Pedra
    • 1
  • Rodrigo Bellio de Mattos Barretto
    • 1
  • Amanda Guerra de Moraes Rego Sousa
    • 1
  1. 1.Instituto Dante Pazzanese de CardiologiaSão PauloBrazil

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